Dr. Sally Bergwerk

Sunday, February 18, 2018

Listeria account for less than 1 percent of reported
cases of bacterial foodborne infection. Most identified cases can be traced
back to contaminated food and the attack rate can be 50-100%. The lucky victims
have subclinical infections.

Common symptoms include
fever, watery diarrhea, nausea, vomiting, headache, and pains in joints and
muscles.The typical duration of symptoms is two days or less, and recovery is
generally complete. Invasive infection seems to be rare, with the risk being
greatest in immunocompromised, pregnant, or older adult patients.Listerial
infection in pregnant women can lead to fetal death, premature birth, or
infected newborns.

The
following represents a compilation of the precautions recommended by the
Centers for Disease Control and Prevention:

The following
additional recommendations were made for individuals at high risk such as
pregnant women and those who are immunocompromised:

●Do not eat hot dogs, luncheon
meats, bologna, or other delicatessen meats unless they are reheated until
steaming hot; avoid the use of microwave ovens for reheating such meats since
uneven cooking may occur.

●Avoid contamination of utensils
and food preparation surfaces with fluid from packages containing hot dogs,
luncheon meats, delicatessen meats, raw meat, chicken, turkey, or seafood.
Handwashing is also important immediately after handling of any of these
products.

●Do not eat soft cheeses such as
feta, Brie, and Camembert, blue-veined cheeses, or Mexican-style cheeses such
as queso blanco, queso fresco, and Panela, unless they have labels that clearly
state they are made from pasteurized milk.

●Do not eat refrigerated pâtés or
meat spreads. However, canned or shelf-stable products are safe and can be
eaten by pregnant women.

●Do not eat refrigerated smoked
seafood, unless it is cooked as in a casserole. Refrigerated smoked seafood,
such as salmon, trout, whitefish, cod, tuna, or mackerel, is most often labeled
as "nova-style," "lox," "kippered,"
"smoked," or "jerky." Such fish products are typically
found in the refrigerator section or sold at deli counters of grocery stores
and delicatessens. However, canned or shelf-stable smoked seafood may be eaten.

Monday, December 25, 2017

A
new shingles shot has been released. The new shot is more effective than the
old one, so much so that adults who received the old vaccine should be
re-immunized with the new one.

Shingles
is caused by the herpes zoster virus, the same one that causes chicken pox. Once a person has had chickenpox, the virus lies inactive in nerve
tissue. Years later, it may reactivate as shingles. The C.D.C. estimates that
about one million cases are diagnosed in the United States each year.

The new vaccine is given in two
doses at least eight weeks apart. However, about 80 percent of individuals had some type of
vaccine reaction, compared to 30 percent of people who got a placebo.

Most symptoms were
mild or moderate. Most common was a sore arm and pain after injection. About
half the people also developed more general side effects, such as muscle ache,
fatigue and headaches that resolved in two to three days. It’s important
to understand that these side effects are expected and resolve fairly quickly,
and they should not discourage anyone from getting the second dose.

About 15 percent of
people who got the vaccine had a reaction that interfered with their normal
daily activities. Those resolved within two to three days.

The cost of the two
shots is estimated to be $280 and insurance coverage may vary.

Sunday, November 26, 2017

Research
shows that eating the same thing every day may help you lose weight. Psychologists believe that eating the same thing every day results in
psychological "habituation" (or boredom), which tends to reduce
calorie intake. Also, when you have a plan in
place it means you’re less likely to make a fast food run or grab the endless
bag of chips.

If you eat the same things day after day you can miss out on important
nutrients. Studies have also found
health benefits associated with eating a more diverse diet. A 2013 study with
over 5200 people found that the greater diversity of healthy foods was
associated with a lower risk of metabolic syndrome. A 2002 study published in
the International Journal of Epidemiology found that increasing the variety of
healthy foods increases life span. Researchers concluded that if you increase
the number of healthy foods regularly, you also tend to decrease the number of
less healthy foods consumed.

Eating a
variety of good foods can play an important role in promoting a greater
bacterial diversity in your gut. Bacterial diversity (the “microbiome”) not
only may keep the weight in check but also can help prevent more serious
illnesses such as diabetes.

What to
do? Whatever works best, everything in moderation.Portion
controlled servings of many foods is generally recognized to the best choice.
Alternatively, you could eat the same thing every day but switch up the menu
every week.

Sunday, November 12, 2017

Vitamins are a number of chemically unrelated families of organic substances that cannot be synthesized by humans but need to be ingested in the diet in small quantities to prevent disorders of metabolism.

Vitamin K plays a crucial role in blood clotting. Vitamin K is found in green vegetables such as spinach and broccoli. The liver and pancreas work together to help the body absorb vitamin K from food. Vitamin K deficiency in a health adult is very rare, but a deficiency can develop with long-term antibiotics or with starvation. Symptoms of vitamin K deficiency include easy bruisability, gum bleeding or blood in the urine.

Vitamin K deficiency is common in the newborn, and if vitamin K is not replaced, the infant is at risk for vitamin K deficient bleeding. Vitamin K is given to infants at birth and infant formula is supplemented. High doses of vitamin A or E can also cause vitamin K deficiency.

Blood thinners, such as warfarin, act to block the action of vitamin K and can be reversed with the administration of vitamin K. Vitamin K toxicity is rare and the upper limit for supplementation is not defined.

Sunday, November 5, 2017

Acute appendicitis is the most common abdominal
surgical emergency in the world. The appendix is a pouch that projects from the
large intestine on the lower right side. The pain often starts near the navel
and then moves to the right side. There is often nausea, vomiting, fever and
chills. The standard treatment is immediate surgical removal; these days the
surgery is most often done via a laparoscope (Band-Aid operation).If not treated, an acutely inflamed appendix
could burst and cause a life-threatening infection.

There are some trials that show that treating acute
appendicitis with antibiotics alone is effective. The risk with this choice is
a recurrent/relapsing infection or missing a hidden cancer. It is easy, even
with sophisticated imaging, to underestimate the severity of disease.Many medical centers have operating rooms
ready to go twenty-four hours per day but it appears safe to wait twelve hours
(the next morning) if the patient presents in the middle of the night.
Antibiotics need to be started immediately in any case.

Thirteen to twenty percent of acute appendices will
perforate (burst). The surgery may be delayed if the diagnosis of perforation
is made initially. The patients are often sicker and delay of surgery allows
stabilization and better antibiotic coverage.

Less than one percent of cases of acute appendicitis
will show a cancer. The diagnosis may not be made until the pathologist reviews
the specimen.

Severe abdominal pain, especially when accompanied
by fever, chills, nausea and vomiting, requires prompt evaluation by a medical
professional. Imaging and blood tests are almost always required. The emergency
department might be the first and best place to seek care.

Sunday, October 22, 2017

The most obvious reason that you have cold feet is because
your feet are cold. If it’s cold enough to wear a jacket and your feet are bare
– maybe you just need to put on some socks. However, there could be medical reasons
that your feet are cold.

It’s possible that not enough (warm) blood is getting to
your feet. This could be due to poor circulation when the heart can’t pump well
enough or from not moving around enough. With exercise, the leg muscles help
the veins return blood to the heart allowing fresh blood to enter the feet.
It’s counter-intuitive, but blood flow is better with leg elevation so too much
sitting can be a problem. Smoking causes blood vessels to constrict, also
reducing reducing blood flow. Raynaud’s phenomenon, which causes blood vessel spasm
from cold, can be so severe as to temporarily cut off blood supply entirely.

An underactive thyroid can reduce the body’s temperature and
heart rate. Both of these can cause cold feet. A partially clogged artery due to high cholesterol will reduce the blood flow to the lower extremities. Not only will there be cold feet, but also pain with exercise since the muscles will not have enough oxygen-rich blood.

Nerve damage can give the sensation that the feet are cold
as well as reduce blood flow. An unfortunately common cause of this kind of
damage is diabetes.

What to do? First, put on a pair of socks and get some
exercise. The next step is to check with your physician to make sure that you
don’t have any underlying disease that causes cold feet.